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An assessment of rates of psychiatric morbidity and functioning in HIV disease
J S McDaniel1, E Fowlie, M B Summerville
1Grady Health System Infectious Disease Program, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30308, USA.
Insights
High rates of psychiatric disorders and functional impairment are prevalent in HIV-infected patients. Early recognition and treatment of mood and anxiety disorders are crucial for improving patient outcomes.
Area of Science:
- Clinical Psychology
- Infectious Diseases
- Psychiatry
Background:
- HIV infection is associated with significant mental health challenges.
- Understanding the prevalence of psychopathology in HIV-positive individuals is critical for effective care.
Purpose of the Study:
- To investigate the rates of psychopathology and functional impairment in HIV-seropositive men and women.
- To identify the most common psychiatric diagnoses in this population.
- To examine the relationship between psychiatric conditions and functional outcomes.
Main Methods:
- Cross-sectional study conducted in a large, urban, public outpatient infectious disease clinic.
- Utilized the Structured Clinical Interview for DSM-III-R to diagnose psychiatric disorders.
- Assessed demographic factors, psychiatric history, and functional impairment.
Main Results:
- Over half of women (53%) and 70% of men met criteria for psychiatric disorders.
- Mood disorders were most common, followed by substance abuse and psychotic disorders.
- Significant functional impairment in physical, social, and role functioning was reported by depressed and anxious patients.
Conclusions:
- HIV-infected patients seeking medical care exhibit substantial psychiatric comorbidity.
- Aggressive psychiatric treatment is essential, especially for depressed and anxious individuals with impaired functioning.
- Highlights the need for integrated mental health services in infectious disease clinics.
Abstract:
This study examined demography, rates of psychopathology, and functional impairment in HIV-seropositive women and men in a large, urban, public outpatient infectious disease clinic. Fifty-three percent of the women and 70% of the men met Structural Clinical Interview for DSM-III-R criteria for psychiatric disorders. Current mood disorders were the most frequent diagnoses, followed by psychoactive substance abuse/dependence disorders and psychotic disorders. Seventy-six percent of the women and 90% of the men had previous psychiatric histories, including 59% of the women and 55% of the men who had psychiatric histories prior to their knowledge of HIV seroconversion. Depressed subjects reported significant impairment in physical, social, and role functioning. Similarly, impairment in physical functioning was highly correlated with self-reported anxiety symptoms. These data suggest considerable past and current psychiatric comorbidity in HIV-infected individuals seeking medical care, and draw attention to the need for recognition and aggressive psychiatric treatment, particularly for those depressed and anxious patients with impaired functioning.